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See a sample rate comparisonCPT 25130 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones In The Hand.
| Key Fact | Detail |
|---|---|
| Service Type | Surgery Surgical Procedures on the Musculoskeletal System |
| Common Place of Service | 24 - Ambulatory Surgical Center 22 - On Campus Outpatient Hospital |
| Common Modifiers | None RT - Right side of body LT - Left side of body |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 25130 |
| Medicaid Fee Schedule | View Medicaid rates for 25130 |
National average reimbursement for CPT 25130 by major payers:
$607.13
$607.59
$631.63
$749.77
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CPT 25130
5 of 25 sample ratesHigher to lower in this preview
Columbia North Hills Hospital Subsidiary Lp, Medical City North Hills
Columbia North Hills Hospital Subsidiary Lp
$9,916.00Published rateNorthwest Surgery Center, LLP, Northwest Surgery Center
Northwest Surgery Center LLP
$3,570.00Published ratePotomac View Surgery Center, LLC
Potomac View Surgery Center LLC
$2,490.00Published rateAlderwood Surgery Center LLC
Alderwood Surgical Center
$1,889.00Published rateRuxton Surgicenter LLC
$1,236.00Published rate
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See a sample payer proposalCPT 25130 vs. Other Surgical Procedures on the Musculoskeletal System Codes
The CPT 25130 code is part of the Surgery services used for Surgical Procedures on the Musculoskeletal System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 25130 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 25130-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones In The Hand. |
| 25135-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25136-CPT | Moderate | Remove Noncancerous Growth, Surgery To Remove A Pocket Of Fluid (Cyst) Or A Noncancerous Growth (Tumor) From One Or More Bones Of The Hand. The Area Is Repaired With A Bone Graft. |
| 25210-CPT | Moderate | Carpectomy Single |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 25130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 25130 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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